January 3, 2011

January 3, 2011
Health Care Problems in Cuba

Welcome to another day in my life. Today is Monday and I hope your week is off to a safe and great start.

Living in south Florida, Dab the AIDS Bear and I have made friends with many new people. Many of these new friends are Hispanic with family ties in Cuba. I was at a meeting where some disturbing news was shared about health care in Cuba.

In one Cuban hospital, patients had to bring their own light bulbs. In another, the staff used a primitive manual vacuum on a woman who had miscarried. In others, Cuban patients pay bribes to obtain better treatment.

Those and other observations by an unidentified nurse assigned to the US diplomatic mission in Havana were included in a dispatch sent by the mission in January 2008 which were recently made public.

The Cuban government still boasts of its vast public health system, though the system suffered deeply after Soviet subsidies ended in 1991. It also blames most of the system's problems on the US embargo. Though US medical sales to Cuba are legal, the process can be cumbersome and Havana can sometimes find better prices elsewhere.

The US cable is not an in depth assessment of Cuba's health system. Rather, it is a string of anecdotes gathered by the FSHP from Cubans such as manicurists, masseuses, hair stylists, chauffeurs, musicians, artists, yoga teachers, tailors, as well as HIV/AIDS and cancer patients, physicians, and foreign medical students.

At one OB-Gyn hospital, the staff used a primitive manual vacuum to aspirate the womb of a Cuban woman who had a miscarriage without any anesthesia or pain medicine. She was offered no follow up appointments.

A 6 year old boy with bone cancer could only be visited at a hospital by his parents for limited hours.

Cancer patients receiving chemotherapy or radiation get little in the way of symptom or side-effects care that is critically important in being able to continue treatments, let alone provide comfort to an already emotionally distraught victim.

Cancer patients are not provided with, nor can they find locally, simple medications such as Aspirin, Tylenol, skin lotions, vitamins, etc.

HIV positive Cubans have only one facility, the Instituto Pedro Kouri in Havana, that can provide specialty care and medications. Because of transportation problems and costs, some patients from the provinces may be seen only once per year.

Kouri institute patients can wait months for an appointment, but can often move ahead in line by offering a gift. We are told five Cuban convertible pesos (approximately USD 5.40) can get one an x-ray.

Although the practice was reportedly discontinued, some HIV positive patients had the letters SIDA (AIDS) stamped on their national ID cards, making it hard for them to find good jobs or pursue university studies.

The cable acknowledged that medical institutions reserved for Cuba's ruling elites and foreigners who pay in hard currencies are hygienically qualified, and have a wide array of diagnostic equipment with a full complement of laboratories, well stocked pharmacies, and private patient suites with cable television and bathrooms.

Hospitals and clinics used by average Cubans do not come close, providing details on the FSHP's visits to four Havana hospitals:

At the Hermanos Ameijeiras Hospital, part of which is reserved for foreign patients and was featured in the Michael Moore documentary Sicko, a gift of about $22 to the hospital administrator helps average Cubans obtain better treatment there. The exterior of the Ramon Gonzalez Coro OB-Gyn hospital was dilapidated and crumbling and its Newborn Intensive Care Unit was using a very old infant `Bird' respirator/ventilator the model used in the US in the 1970s.

During a visit to the Calixto Garcia Hospital, which serves only Cubans, the US nurse was struck by the shabbiness of the facility and the lack of everything (medical supplies, privacy, professional care staff). To the FSHP it was reminiscent of a scene from some of the poorest countries in the world.

At the Salvador Allende Hospital, the emergency room appeared very orderly, clean and organized. But the rest of the facility was in shambles and guards by the entrance smelled of alcohol.

Patients had to bring their own light bulbs if they wanted light in their rooms. The switch plates and knobs had been stolen from most of the rooms so one had to connect bare wires to get electricity.

While this horrifies me and makes me empathize with the people in Cuba; the others sitting in the room shook their heads with concurrence. It just explains one more reason why so many are willing to risk their lives to get to America.

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab